Provider Demographics
NPI:1376664409
Name:ROXAS, MARIA CARIDAD (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:CARIDAD
Last Name:ROXAS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 QUARTZ ST
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:CA
Mailing Address - Zip Code:92251-2510
Mailing Address - Country:US
Mailing Address - Phone:760-355-8479
Mailing Address - Fax:760-352-8911
Practice Address - Street 1:1501 W MAIN ST
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-2211
Practice Address - Country:US
Practice Address - Phone:760-352-5731
Practice Address - Fax:760-352-9811
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59236183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist